Asthma in Michigan Prepared by Epidemiology and Surveillance Staff of the Asthma Initiative of...

Asthma in Michigan

Prepared by Epidemiology and Surveillance Staff of the Asthma Initiative of Michigan, Michigan Department of Community Health

Last Updated February 2006

Overview of Presentation

What is Asthma? The Asthma Initiative of Michigan Asthma Surveillance in Michigan Asthma Prevalence Asthma Management and Quality of Life Work-Related Asthma Asthma Hospitalization Asthma Mortality Healthy People 2010 Goals for Asthma

What is asthma?

Asthma Defined

Chronic inflammatory disease of the airways Causes recurrent episodes of

– Wheezing– Breathlessness– Chest tightness– Coughing

Episodes are usually associated with airflow obstruction that is often reversible either spontaneously or with treatment

Guidelines for the Diagnosis and Management of Asthma, NIH Publication 97-4051, July 1997.

Risk Factors for Developing Asthma

Family history of asthma Sociodemographic factors:

– Prepubescent males– Post-pubescent females – Low socioeconomic status– Minority races

Allergy or family history of allergy Premature birth Low birth weight Small airways at birth Environmental exposures: Indoor & Outdoor (?)

During an asthma attack…

Mechanisms Underlying the Definition of Asthma

Adapted with permission from Stephen T. Holgate, M.D., D.Sc.Guidelines for the Diagnosis and Management of Asthma, NIH Publication 97-4051, July 1997.

Environmental Risk Factors (Causes)Environmental Risk Factors (Causes)

Airflow Airflow LimitationLimitation

Airway Airway HyperresponsivenessHyperresponsiveness

PrecipitantsPrecipitantsSymptomsSymptoms

INFLAMMATION

Triggers of Asthma Attacks

Narrowing of airways occurs in response to inflammation or hyperresponsiveness to triggers, including:– Allergens– Infections– Diet/Medications– Strong Emotions– Exercise– Cold temperature– Exposure to irritants

The Asthma Initiative of Michigan

Recommendation Categories of the Michigan Asthma Strategic Planning Initiative Task Force (MASPI) Foundation for Michigan Asthma Activities

Training for Clinical Diagnosis, Disease Management, and Asthma Education Services

Access to and Coordination of Health Care and Education Services

Environmental Action

Community Action

Asthma Epidemiology & Surveillance Work Group

Asthma in Schools Work Group

Environmental Quality Work Group

Evaluation Committee

Michigan Asthma Communication Network

Committee

Quality Improvement in Asthma Care Work Group

•Asthma Coalition for Northeast MI

•Asthma Coalition of Northwest MI•Asthma Network of West MI•Detroit Alliance for Asthma

Awareness•Eastern Upper Peninsula Asthma

Coalition•Genesee Co. Childhood Asthma

Task Force •Grayling Asthma Project•Jackson Asthma Coalition

•Kalamazoo Area Asthma Coalition•Mid-Michigan Asthma Coalition•Southwest MI Asthma Coalition

•Tri-County Asthma Coalition•Washtenaw Asthma Coalition

Asthma Coalitions of Michigan•Asthma Coalition for Northeast MI•Asthma Coalition of Northwest MI•Asthma Network of West MI•Detroit Alliance for Asthma Awareness•Eastern Upper Peninsula Asthma Coalition•Genesee Co. Childhood Asthma Task Force •Grayling Asthma Project•Jackson Asthma Coalition•Kalamazoo Area Asthma Coalition•Mid-Michigan Asthma Coalition•Southwest MI Asthma Coalition•Tri-County Asthma Coalition•Washtenaw Asthma Coalition

Asthma Surveillance

Asthma Surveillance – The Ideal

Track asthma occurrence and severity Identify regional/demographic variations Monitor asthma management & control, access

to care, and quality of life Track prevalence of risk factors and exposure

to triggers Monitor the effectiveness of public health

interventions

Asthma Surveillance – A Conceptual Model

Asthma Prevalence

Causal Factors

Pharmacy

Claims

Scheduled

Office Visit

Unscheduled

Office Visit

ED/Urgent

Care

Hospitaliza

tion

Mortality

Triggers Management Quality of Life Access

Asthma Surveillance in Michigan Prevalence

– Adult: Self report from the Michigan Behavioral Risk Factor Surveillance Survey (BRFSS) core questions

– Child: Self report from the BRFSS, 18 years; Self report from the Youth Tobacco Survey (YTS), grades 6-12; Self report from the Youth Risk Behavior Survey (YRBS), grades 9-12.

Quality of Life and Asthma Management– Self Report from the BRFSS core and asthma module questions -

Adults with current asthma only– School Health Education Profile (SHEP) Survey

Work-Related Asthma– Self Report from state added questions to the BRFSS– SENSOR surveillance of sentinel work-related asthma incidence

Hospitalization – Michigan Inpatient Database– Primary Diagnosis at Discharge, ICD-9-CM 493.XX

Mortality – Michigan Resident Death File– Primary Cause of Death, 1990-1998: ICD-9 493, 1999-present:ICD-10

J45 and J46

Asthma Prevalence

Prevalence Current Asthma for Children (<18 Years) and Adults (18 Years), Michigan

9.1 8.30

2

4

6

8

10

12

Child (2002) Adult (2004)

Per

cen

t

Data Source: Michigan Behavioral Risk Factor Survey, 2002 and 2004

Prevalence of Current Asthma for Adults ( 18 Years) by Race, Michigan, 2004

8.0 8.40

2

4

6

8

10

12

White Black

Per

cen

t

Data Source: Michigan Behavioral Risk Factor Survey, 2004

Prevalence of Current Asthma for Adults ( 18 Years) by Education, Michigan, 2004

11.4 7.5 9.0 7.40

4

8

12

16

20

Per

cen

t

< High SchoolHigh School GraduateSome CollegeCollege Graduate


Prevalence of Current Asthma for Adults ( 18 Years) by Household Income, Michigan, 2004

11.5 9.7 6.4 6.8 6.70

4

8

12

16

20

Per

cen

t

<$20,000$20,000-$34,999$35,000-$49,999$50,000-$74,999$75,000+


Health Care Coverage for Michigan Adults ( 18 Years) by Current Asthma Status, 2004

85.6 14.488.0 12.00

20

40

60

80

100

Health Coverage No Health Coverage

Per

cen

t

Asthma

No Asthma


Prevalence of Lifetime Asthma for Children in Middle and High School, Michigan, 2003

20.5 22.20

5

10

15

20

25

Middle School High School

Per

cen

t

Data Source: Youth Tobacco Survey, 2003

Prevalence of Lifetime Asthma for Children in High School by Race, Michigan, 2003

20.5 25.2 17.0 21.10

5

10

15

20

25

30

Per

cen

t

White Black Hispanic Total

Data Source: Youth Risk Behavior Survey, 2003

Quality of Life and Disease Management for People with Asthma

Perceived Health Status for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004

72.5 27.586.9 13.10

20

40

60

80

100

Excellent/Very Good/Good Fair/Poor

Per

cen

t

Asthma

No Asthma*

*

* Statistically significant, p < 0.05


Cigarette Smoking for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004

25.4 24.9 49.823.2 25.3 51.50

20

40

60

80

100

Current Smoker Former Smoker Never Smoker

Per

cen

t

Asthma

No Asthma


Weight Status for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004

39.2 26.1 34.739.1 36.4 24.50

20

40

60

80

100

Not Overweight Overweight Obese

Per

cen

t

Asthma

No Asthma

* *

* Statistically significant, p < 0.05Data Source: Michigan Behavioral Risk Factor Survey, 2004

Illness/Symptoms Caused by Poor Air Quality for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004

46.4 22.820.6

7.8

0

20

40

60

80

100

Poor IA Quality Poor OA Quality

Per

cen

t

Asthma

No Asthma

Cook ML, Rafferty AP. 2005. Health Risk Behaviors in the State of Michigan: 2004 Behavioral Risk Factor Survey. Lansing, MI: MDCH, Bureau of Epidemiology, Epidemiology Services Division.

*

*

* Statistically significant, p < 0.05

Leisure-Time Physical Activity in the Last Month for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004

73.2 26.878.4 21.60

20

40

60

80

100

LT Physical Activity No LT Physical Activity

Per

cen

t

Asthma

No Asthma


Flu Vaccination in the Past Year for Adults ( 18 Years) by Current Asthma Status, Michigan, 2004

40.2 59.830.9 69.10

20

40

60

80

100

Flu Vaccine No Flu Vaccine

Per

cen

t

Asthma

No Asthma

*

*

* Statistically significant, p < 0.05Data Source: Michigan Behavioral Risk Factor Survey, 2004

Frequency of Asthma Medication Use in the Past 30 Days Among Adults ( 18 Years) with Current Asthma, Michigan, 2004

33.0

6.9

14.2

45.9

None

Less Than Weekly

Weekly

Daily


Percent of Adults ( 18 Years) with Current Asthma that have Seen a Health Care Professional for a Routine Checkup of the Asthma in the Past 12 Months, Michigan, 2004

41.0 27.9 31.10.0

10.0

20.0

30.0

40.0

50.0

No Checkups 1 Checkup 2 or MoreCheckups

Per

cen

t


Percent of Adults ( 18 Years) with Current Asthma that have Sought Urgent Asthma Treatment from either a Health Care Professional or Emergency Department/Urgent Care Center in the Past 12 Months, Michigan, 2004

10.5 11.116.3 7.90

4

8

12

16

20

Health Care Professional ED/Urgent Care Center

Per

cen

t

1 Visit 2 or More Visits


Occurrence of Asthma Symptoms in the Past 30 Days Among Adults ( 18 Years) with Current Asthma, Michigan, 2004

26.8

20.433.0

19.8

None

< 1 Per Week

Weekly

Daily


Occurrence of Sleep Disturbing Asthma Symptoms in the Past 30 Days Among Adults ( 18 Years) with Current Asthma, Michigan, 2004

53.3

22.5

15.1

9.1

None

1 to 2 Days

3 to 10 Days

11 or More Days


Number of Days Unable to Work or Carry Out Usual Activities due to Asthma in the Past 12 Months for Adults ( 18 Years) with Current Asthma Michigan, 2004

70.7 22.27.1

0

15

30

45

60

75

None 1 to 10 Days 11 or More Days

Per

cen

t


Symptom Severity for Michigan Adults with Asthma who took Asthma Medication Daily in the Past 30 Days, 2002 - 2004

Severe Persistent

20.0%

Moderate Persistent

33.5%

Mild Intermittent

29.2%

Mild Persistent

17.3%


Prevalence of School-based Asthma Management Activities Among Public Schools with Grade 6 or higher, Michigan, 2004

Activity Percent of Schools

Full time registered nurse. 12.0%

Identify & track all students with asthma. 72.3%

Obtain & use an asthma action plan for students with asthma.

43.2%

Assure immediate access to medications prescribed by a physician & approved by parents.

94.2%

Provide intensive case management for students with asthma missing 10+ school days per year.

21.9%

Data Source: School Health Education Profile (SHEP) Survey, 2004

Prevalence of School-based Asthma Management Activities Among Public Schools with Grade 6 or higher, Michigan, 2004, Cont.

Activity Percent of Schools

Educate school staff about asthma. 50.1%

Educate students with asthma about asthma management.

24.4%

Teach asthma awareness to all students in at least 1 grade.

21.4%

Encourage full participation in physical education & activity when students with asthma are doing well.

95.2%

Provide modified physical education and activities as indicated by the student’s asthma action plan.

79.4%

Data Source: School Health Education Profile (SHEP) Survey, 2004

Work-Related Asthma

Proportion of Adults whose Current Asthma May be Work-Related, Michigan, 2004

4.9 8.9 10.20

2

4

6

8

10

12

14

Current Asthma

Per

cen

t

Doctor

Respondent

Either


Identified by:

Proportion of Confirmed Work-Related Asthma Patients by Major Industry Type, Michigan, 1988-2004

3.0 4.07.0

19.0

67.0

Construction/Mining

Trade

Miscellaneous

Services

Manufacturing

Data Source: Rosenman KD, Reilly MJ, and Kalinowski DJ. 2004 Annual Report on Work-Related Asthma in Michigan. (http://oem.msu.edu//asthma/04AsthmaAnnRpt_all.pdf)

Hospitalization for Asthma

Rates* of Hospitalization due to Asthma by Sex, All Ages, Michigan, 2001-2003

13.0 17.9 15.60

5

10

15

20

Male Female Total

Ra

te p

er

10

,00

0

*Uses 2002 MI population estimates and age adjusted to the 2000 US standard population.Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

0

5

10

15

20

25

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Ra

te p

er

10

,00

0

Male Female Total

Rates* of Hospitalization due to Asthma by Sex and Year, All Ages, Michigan, 1990-2003

*Uses 1990-2003 MI population estimates and age adjusted to the 2000 US standard population.Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Rates* of Hospitalization due to Asthma by Age Group, All Ages, Michigan, 2001-2003

48.7 15.2 8.1 14.2 18.50

10

20

30

40

50

0 to 4 5 to 14 15 to 34 35 to 64 65 and Older

Ra

te p

er

10

,00

0

*Uses 2002 MI population estimates.Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Rates* of Hospitalization due to Asthma by Age Group and Year, All Ages, Michigan, 1990-2003

0

10

20

30

40

50

60

70

80

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Rat

e p

er 1

0,00

0

0 to 45 to 1415 to 3435 to 6465 and Older

*Uses 1990-2003 MI population estimates.Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Rates* of Hospitalization due to Asthma by Race, All Ages, Michigan, 2001-2003

10.6 43.40

10

20

30

40

50

White Black

Ra

te p

er

10

,00

0


Rates* of Hospitalization due to Asthma by Race and Year, All Ages, Michigan, 1990-2003

0

10

20

30

40

50

60

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Rat

e p

er 1

0,00

0

White Black

*Uses 1990-2003 MI population estimates and age adjusted to the 2000 US standard population.Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Rates* of Hospitalization due to Asthma by Sex, Age Group, and Race, All Ages, Michigan, 2001-2003

0

20

40

60

80

100

120

140

160


Ra

te p

er

10

,00

0

White MaleWhite FemaleBlack MaleBlack Female


Rates* of Asthma Hospitalization by Race and Income**, All Ages, Michigan, 2000-2002

34.7 15.3 56.313.6 11.3 36.18.4 8.4 19.60

10

20

30

40

50

60

Total White Black

Low Income

Middle Income

High Income

Rat

e p

er 1

0,00

0

*Uses 2000 MI population and age adjusted to the 2000 US standard population.**Income level determined by ranking median household income for zip codes from Census 2000.Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Rates* of Hospitalization due to Asthma by Age Group and Month of Admission, All Ages, Michigan, 2001-2003

012345678

Rat

e pe

r 10

,000



Average Length of Stay for a Hospitalization due to Asthma by Year, All Ages, Michigan, 1990-2003

4.2 4.2 4.1 4.1 3.9 3.5 3.3 3.2 3.2 3.2 3.0 3.1 3.1 3.10

1

2

3

4

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Aver

ag

e N

um

ber

of

Days

Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Average Length of Stay for a Hospitalization due to Asthma by Age Group and Year, All Ages, Michigan, 1990-2003

0

2

4

6

8

10

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Rat

e p

er 1

0,00

0


Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Estimates of Average Cost for an Asthma Hospitalization in Michigan, 2001 $7,001 By Sex

– Males: $6,209– Females: $7,522

By Race– Whites: $6,564– Blacks: $7,137

Generally the average cost of an asthma hospitalization increases with age: $4,927 for children <1 year to $9,836 for adults 65 years.

Data Source: Healthcare Cost and Utilization Project, 2001; http://www.ahrq.gov/data/hcup/hcupnet.htm

Rate per 10,000

5.2 – 11.211.3 – 17.217.3 – 23.223.3 – 29.3Insufficient Data**

Rate higher than Michigan Rate

Rates* of Hospitalization due to Asthma by County of Residence, All Ages, Michigan, 2001-2003

State of Michigan Rate:15.6 (15.4, 15.7)

*Uses 2002 MI population estimates and age adjusted to the 2000 US standard population.**Number of events 20 or <5000 populationData Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Rate per 10,000



Rates* of Hospitalization due to Asthma for Children <18 Years by County of Residence, Michigan, 2001-2003



Rate per 10,000



Rates* of Hospitalization due to Asthma for Adults 18 Years by County of Residence, Michigan, 2001-2003



Rate per 10,000



Rates* of Hospitalization due to Asthma by County of Residence for White Persons, All Ages, Michigan, 2001-2003



Rate per 10,000



Rates* of Hospitalization due to Asthma by County of Residence for Black Persons, All Ages, Michigan, 2001-2003



Asthma Mortality

Rates* of Mortality due to Asthma by Sex, All Ages, Michigan, 2001-2003

12.6 16.1 14.60

5

10

15

20

Male Female Total

Ra

te p

er

1,0

00

,00

0

*Uses 2002 MI population estimates and age adjusted to the 2000 US standard population.Data Source: Michigan Resident Death Files, Bureau of Epidemiology, MDCH.

Rates* of Mortality due to Asthma by Sex and Year, All Ages, Michigan, 1990-2003

0

5

10

15

20

25

30

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Rat

e p

er 1

,000

,000

Male Female Total

*Uses 1990-2003 MI population estimates and age adjusted to the 2000 US standard population.Data Source: Michigan Resident Death Files, Bureau of Epidemiology, MDCH.

Rates* of Mortality due to Asthma by Age Group, All Ages, Michigan, 2001-2003

14.2 50.67.7

4.3

0

10

20

30

40

50

60

70


Ra

te p

er

1,0

00

,00

0

**

*Uses 2002 MI population estimates and age adjusted to the 2000 US standard population.**Number of deaths <5 and >0.Data Source: Michigan Resident Death Files, Bureau of Epidemiology, MDCH.

Rates* of Mortality due to Asthma by Age Group and Year, Michigan, 1990-2003

0

20

40

60

80

100

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Rat

e p

er 1

,000

,000

15 to 34 35 to 64 65 and Older


Rates* of Mortality due to Asthma by Race, All Ages, Michigan, 2001-2003

10.5 41.10

10

20

30

40

50

White Black

Ra

te p

er

1,0

00

,00

0

*Uses 2002 MI population estimates and age adjusted to the 2000 US standard population.Data Source: Michigan Resident Death Files, Bureau of Epidemiology, MDCH.

Rates* of Mortality due to Asthma by Race and Year, All Ages, Michigan, 1990-2003

0

10

20

30

40

50

60

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Rat

e p

er 1

,000

,000

White Black


Rates* of Mortality due to Asthma by Sex and Age Group and Year, All Ages, Michigan, 2001-2003

11.1 37.217.2 60.17.95.3 7.4

3.30

20

40

60

80


Ra

te p

er

1,0

00

,00

0

Male Female

**

*Uses 2002 MI population estimates and age adjusted to the 2000 US standard population.**Number of deaths <5, there were 0 deaths among females, age 0-4 years.Data Source: Michigan Resident Death Files, Bureau of Epidemiology, MDCH.

Rates* of Mortality due to Asthma by Race and Age Group and Year, All Ages, Michigan, 2001-2003

48.254.9 78.18.1

4.11.5 26.316.30

20

40

60

80


Ra

te p

er

1,0

00

,00

0

White Black

**

*Uses 2002 MI population estimates and age adjusted to the 2000 US standard population.**Number of deaths <5 and >0.Data Source: Michigan Resident Death Files, Bureau of Epidemiology, MDCH.

The Healthy People 2010 Objectives for Asthma

For information about the Healthy People 2010 Initiative, visit: www.healthypeople.gov/

The Healthy People 2010 Objectives for Asthma Reduce hospitalization rates for three ambulatory-care-sensitive

conditions: pediatric asthma, uncontrolled diabetes, and immunization preventable pneumonia and influenza. (1-9a)

Reduce asthma deaths. (24-1) Reduce hospitalizations for asthma. (24-2) Reduce emergency department visits for asthma. (24-3) Reduce activity limitations among persons with asthma. (24-4) Reduce the number of school or workdays missed by persons

with asthma due to asthma. (24-5) Increase the proportion of persons with asthma who receive

formal patient education, including information about community and self-help resources, as an essential part of the management of their condition. (24-6)

Increase the proportion of persons with asthma who receive appropriate asthma care according to the National Asthma Education and Prevention Program (NAEPP) Guidelines. (24-7)

Rates of Hospitalization due to Asthma Compared to Healthy People 2010 Target for Objective 1-9a, Children < 18 Years, Michigan, 1990-2003

0

10

20

30

40

'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03

Rat

e p

er 1

0,,0

00

Michigan Target

*Uses 1990-2003 MI population estimates.Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Rates of Mortality due to Asthma Compared to Healthy People 2010 Target for Objective 24.1, Age >14 Years, Michigan, 1990-2003

0

20

40

60

80

90 92 94 96 98 00 02 90 92 94 96 98 00 02 90 92 94 96 98 00 02

15 to 34 35 to 64 65 and Older

Michigan

HP 2010 Target

*Uses 1990-2003 MI population estimates.Data Source: Michigan Resident Death Files, Bureau of Epidemiology, MDCH.

Rat

e pe

r 1,

000,

000

Rates* of Hospitalization due to Asthma by Race Compared to Healthy People 2010 Target for Objective 24-2, All Ages, Michigan, 1990-2003

0

40

80

120

160

90 92 94 96 98 00 02

Ra

te p

er

10,0

00

90 92 94 96 98 00 02 90 92 94 96 98 00 02

0 to 4 5 to 64** 65 and Older**

Black

White

HP 2010 Target

*Uses 1990-2003 MI population estimates.**Age-adjusted to the 2000 US standard population.Data Source: Michigan Inpatient Database, Bureau of Epidemiology, MDCH.

Sig. < Target

Not Sig. Different Than Target

Sig. > Target

20 Events


County Level Attainment of the Healthy People 2010 Target for Rate* of Asthma Hospitalization for Objective 24-2, Age 0 to 4 Years, Michigan, 2001-2003



HP 2010 Target Rate:25 per 10,000

Sig. < Target


Sig. > Target

20 Events


County Level Attainment of the Healthy People 2010 Target for Rate* of Asthma Hospitalization for Objective 24-2, Age 5 to 64 Years, Michigan, 2001-2003


HP 2010 Target Rate:7.7 per 10,000


Sig. < Target


Sig. > Target

20 Events


County Level Attainment of the Healthy People 2010 Target for Rate* of Asthma Hospitalization for Objective 24-2, Age 65 Years and Over, Michigan, 2001-2003


HP 2010 Target Rate:11 per 10,000


Data Summary

233,900 children and 629,100 adults currently have asthma in Michigan.

55% of Michigan adults with asthma had an asthma attack in the last year.

20% of Michigan adults with asthma are experiencing asthma symptoms every day.

10% of Michigan adults with asthma report that their asthma is work-related.

Asthma hospitalization rates are highest in very young children, age 0 to 4 years.

Hospitalization rates for blacks are over 4 times the rate for whites.

Data Summary Cont.

Rates of asthma hospitalization are higher in low income areas than high income areas.

Asthma causes 153 deaths each year in Michigan. Mortality rates are significantly higher among blacks

than whites. In all age groups, some counties of Michigan have

asthma hospitalization rates equal to or lower than the Healthy People 2010 targets.

In recent years, Michigan has met the Healthy People 2010 target for asthma mortality among those age 65 years and older.

For more information:

Visit the Asthma Initiative of Michigan Website:

Call Toll Free:

1.866.395.8647

Acknowledgements

The Asthma Epidemiology and Surveillance Workgroup of the Michigan Asthma Advisory Committee

This project is supported by Cooperative Agreement Number U59/CCU517742 from the Centers for Disease Control (CDC). Contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

If you have questions about the data or have a specific data request, please contact the Epidemiology and Surveillance staff of the Asthma Initiative of Michigan:

Betsy Wasilevich, MPH Asthma Epidemiologist 517.335.8164 [email protected]

Asthma in Michigan Prepared by Epidemiology and Surveillance Staff of the Asthma Initiative of...

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